Retrospective Cohort Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2018; 6(5): 74-83
Published online May 16, 2018. doi: 10.12998/wjcc.v6.i5.74
Effect and safety of sorafenib in patients with intermediate hepatocellular carcinoma who received transarterial chemoembolization: A retrospective comparative study
Xue-Fen Lei, Yang Ke, Tian-Hao Bao, Hao-Ran Tang, Xue-Song Wu, Zhi-Tian Shi, Jie Lin, Zhi-Xian Zhang, Hou Gu, Lin Wang
Xue-Fen Lei, Jie Lin, Zhi-Xian Zhang, Hou Gu, Department of Medical Oncology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
Yang Ke, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
Tian-Hao Bao, The Mental Health Center of Kunming Medical University, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
Hao-Ran Tang, Xue-Song Wu, Department of Gastroenterological Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
Zhi-Tian Shi, Lin Wang, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Kunming Medical University; Kunming 650101, Yunnan Province, China
Author contributions: Lei XF, Ke Y, Bao TH, Tang HR and Wang L contributed to the conception and design; Lei XF, Ke Y, Bao TH, Tang HR, Wu XS and Shi ZT contributed to the collection and assembly of data; Lei XF, Ke Y, Bao TH, Tang HR, Lin J, Zhang ZX and Gu H contributed to the analysis and interpretation of data; Lei XF, Ke Y, Bao TH and Tang HR contributed to the drafting of the manuscript; Lei XF, Ke Y, Bao TH, Tang HR contributed equally to this work.
Supported by National Natural Science Foundation of China, No. 81360360 and No. 81660399; Yunnan Provincial Engineering Research Center of Major Surgical Diseases (2014); Innovation Research Team Project of Yunnan Institutions of Higher Education (2014); Innovation Research Team Project of Yunnan Province, No. 2015HC033; Yunnan Provincial Academician Workstation of Xiaoping Chen (2016); Breeding Program for Major Scientific and Technological Research Achievements of Kunming Medical University, No. CGPY201607; and the Medical Leading Talent Project of Yunnan Province (to Wang L), No. L201622.
Institutional review board statement: This study was reviewed and approved for publication by our Institutional Reviewer.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lin Wang, PhD, Professor, Surgical Oncologist, Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Kunming Medical University, 1168 Chunrongxi Road, Kunming 650500, Yunnan Province, China. wanglin@acgxg.com
Telephone: +86-871-63402861 Fax: +86-871-65335752
Received: January 13, 2018
Peer-review started: January 13, 2018
First decision: February 27, 2018
Revised: March 4, 2018
Accepted: March 19, 2018
Article in press: March 20, 2018
Published online: May 16, 2018
Processing time: 123 Days and 3 Hours
Abstract
AIM

To evaluate the safety and efficacy of sorafenib plus transarterial chemoembolization (TACE) treatment for intermediate hepatocellular carcinoma (HCC).

METHODS

Sixty-seven patients with intermediate-stage [Barcelona Clinic liver cancer stage B (BCLC-B)] HCC who were treated with sorafenib plus TACE or TACE alone between 2009 and 2011 were included in the study. Follow-up was until 2014 or patient death. Two groups were defined in the experiment: The experimental group, treated with sorafenib plus TACE, and the control group, treated with standard TACE alone.

RESULTS

The Kaplan-Meier survival analysis showed that the median overall survival (mOS) of the experimental group was 35.2 mo, while that of the control group was 22.0 mo (P < 0.05). Sorafenib plus TACE showed higher incidence rates of rash, hand-foot syndrome (HFS), and hypertension (P < 0.05) than TACE treatment alone.

CONCLUSION

Sorafenib plus TACE treatment for BCLC-B HCC significantly prolonged the mOS of patients compared to TACE treatment alone. The most common toxicities with sorafenib were rash (31.6%), HFS (39.5%) and hypertension (31.6%), but there were no intolerable adverse events. The Cox multivariate analysis showed that the survival of patients with BCLC-B HCC depended on the Child-Pugh classification, tumor diameter, and treatment with sorafenib plus TACE compared to TACE alone.

Keywords: Sorafenib; Hepatocellular carcinoma; Transarterial chemoembolization; Overall survival; Adverse reaction

Core tip: Hepatocellular carcinoma (HCC) is a common digestive tract malignancy. Transarterial chemoembolization (TACE) is the standard treatment for intermediate-stage HCC, and it has a limited beneficial effect. To evaluate the safety and efficacy of sorafenib plus TACE treatment for intermediate-stage HCC. Sixty-seven patients with intermediate-stage HCC who were treated with sorafenib plus TACE or TACE alone between 2009 and 2011 were included in the study. This study confirms that sorafenib plus TACE treatment for intermediate-stage HCC significantly prolonged the median overall survival of patients compared to TACE treatment alone. Moreover, this new treatment approach showed tolerable toxicity.